| NPI | 1164608964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 51926) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036123996) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2018-01-17 |